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Avascular necrosis of bilateral femoral heads

Case contributed by Alexander Ortiz
Diagnosis certain

Presentation

Difficulties ambulating due to bilateral hip pain for the previous 10 months that has led to the use of a wheelchair due to the inability to walk more than a short distance; past medical history of rheumatoid arthritis and sickle cell anemia

Patient Data

Age: 48 years
Gender: Female

Avascular necrosis involving both femoral heads is seen depicted by a region with a hypointense serpiginous peripheral rim and inner hyperintense area on T2WI. Double line sign is also seen on axial STIR images in the sacrum on the left side.

Case Discussion

The findings seen in this case in a patient with past medical history of sickle cell anemia and difficulties ambulating due to bilateral hip pain is consistent with avascular necrosis of both femoral heads.

Case courtesy of Dr Guillermo Bolivar

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